NPIMap

Individual provider Active NPI

Anissa Ittner, PA-C

  • Physician Assistant
  • Newark, NJ
National Provider Identifier
1740959311
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
90 Bergen St Ste 8100
Newark, NJ 07103-2425
Phone
(973) 972-2323
NPI assigned
Sep 8, 2021
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

90 Bergen St Ste 8100
Newark, NJ 07103-2425

Mailing address

90 Bergen St Ste 8100
Newark, NJ 07103-2425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211122000945 NJ Practitioner - Physician Assistant 7719376318 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19 Davis Ave
Neptune, NJ 07753-4488

30 Prospect Ave
Hackensack, NJ 07601-1915

425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone (732) 836-4504

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jun 27, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Mar 6, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Mar 6, 2023 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Oct 4, 2021 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Oct 4, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jun 27, 2025 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

90 Bergen St
Ste 8100
Newark, NJ 07103
Phone (973) 972-0037

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1740959311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITTNER",
        "first_name": "ANISSA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.